Hyperthyroidism is hyperthyroidism, which is a very common endocrine disease in clinic. It refers to a series of hypermetabolic syndrome, symptoms of hyperexcitability and ocular symptoms of nervous system, circulatory system, digestive system and cardiovascular system caused by excessive secretion of thyroid hormone or elevated levels of thyroid hormone (T3, T4) in blood for various reasons. Clinically, patients with hyperthyroidism mainly show palpitation, tachycardia, fear of heat, sweating, overeating, emaciation, emaciation, fatigue, irritability, impatience, insomnia, inattention, exophthalmos, trembling hands and tongue, goiter or enlargement, menstrual disorder or even amenorrhea in women, impotence or breast development in men, etc. Goiter is symmetrical, and some patients are asymmetrical. Goiter or enlargement will move up and down with swallowing, and some patients with hyperthyroidism have thyroid nodules. Eye changes caused by hyperthyroidism, one is benign exophthalmos, the patient's eyeball protrudes, his eyes stare or show frightened eyes; The other is malignant exophthalmos, which can be transformed from benign exophthalmos Patients with malignant exophthalmos often have photophobia, tears, diplopia, decreased vision, eye swelling and pain, tingling, foreign body sensation and so on. Because the eyeball is highly prominent, you can't close your eyes, and the conjunctiva and cornea are exposed, causing congestion, edema and corneal ulceration. , even blind. Some patients with hyperthyroidism have no ocular symptoms or the symptoms are not obvious. All the above are typical clinical manifestations of hyperthyroidism, but not every hyperthyroidism patient has all clinical symptoms. Different types of hyperthyroidism have different clinical manifestations.

2. What are the main types of hyperthyroidism?

Clinically, in addition to the typical hyperthyroidism, the common ones are:

(1)T3 hyperthyroidism. T3 hyperthyroidism refers to a kind of hyperthyroidism with clinical manifestations, but the serum TT4 and FT4 are normal or even low, and only T3 is elevated.

(2)T4 hyperthyroidism. There are clinical manifestations of hyperthyroidism, but the serum T4 is elevated, or FT4 is elevated, and T3 is normal. Such as: iodine hyperthyroidism, thyroiditis, T4 hyperthyroidism and other acute or chronic systemic diseases.

(3) hyperthyroidism in children. After 3 years old, the incidence rate gradually increased. The incidence rate was the highest at 1 1- 16 years old, with more girls than boys. All children have diffuse goiter and typical hypermetabolic syndrome, and exophthalmos is more common.

(4) hyperthyroidism in the elderly. Due to the physiological changes of the elderly, the function of the whole body organs has declined to varying degrees, the thyroid tissue has a certain degree of fibrosis and atrophy, the secretion of thyroid hormone has decreased, and the response of peripheral tissues to thyroid hormone has also changed. The clinical characteristics of hyperthyroidism in the elderly are: the thyroid gland is often not enlarged, or slightly enlarged, mostly accompanied by nodules; Exophthalmos is not obvious or prominent, hypermetabolic syndrome is not obvious, lack of appetite, fear of heat and sweating, irritability and other symptoms; Often complicated with angina pectoris and even myocardial infarction and other heart diseases, it is prone to arrhythmia and heart failure, especially persistent atrial fibrillation; The patient shows indifference and no desire, and in severe cases, he is sleepy or unconscious. For the treatment of hyperthyroidism in the elderly, experts emphasize the importance. Quot Long-term Efficacy of Compound Jiakangping Capsule ".

(5) indifferent hyperthyroidism. This type is a special manifestation of hyperthyroidism. The symptoms are contrary to typical hyperthyroidism, which is characterized by nerve inhibition. Clinical manifestations of indifferent hyperthyroidism: loss of appetite, nausea, chills, dry skin, apathy and depression, and indifference to surrounding things; Mental thinking activities are slow, while answering questions slowly, sometimes it is difficult to concentrate and lazy to talk less; Palpitation is common, often accompanied by heart enlargement, congestive heart failure, atrial fibrillation, sunken eye socket, dull eyes and even drooping eyelids. In the treatment of this disease, experts even chose the traditional Chinese medicine "Compound Jiakangping Capsule" to achieve the effect of balancing yin and yang, and the treatment method is the same as that of ordinary hyperthyroidism.

(6) Concealed hyperthyroidism. Concealed hyperthyroidism refers to a kind of hyperthyroidism characterized by a systemic disease without typical hyperthyroidism symptoms. The clinical types are ① mental type. Mental disorders are prominent manifestations. Patients are characterized by inattention, inattention, hallucinations, delusions, depression, dementia, paranoia and mania, and even suicidal thoughts and rage attacks. ② Gastrointestinal type. Diarrhea is often a prominent manifestation. It is more common in young and middle-aged patients, and the frequency of defecation varies from several times a day to more than a dozen times. It is pasty or watery and contains undigested food. Some patients mainly show vomiting or abdominal pain. Gastrointestinal hyperthyroidism has vomiting and diarrhea, often accompanied by water and electrolyte disorders. If not treated properly, it is easy to induce hyperthyroidism crisis and endanger life. ③ Myopathy type. The main manifestations are muscle weakness and periodic paralysis. Symptoms of hyperthyroidism are not obvious or appear late. The clinical manifestations are acute and chronic hyperthyroidism myopathy, periodic paralysis, myasthenia gravis and ophthalmoplegia.

Hypersecretion of thyroid hormone in hyperthyroidism promotes metabolism of essence, fat and protein, and accelerates oxidation. The body's heat production and heat dissipation are obviously increased, and the basal metabolic rate is abnormally increased. It is necessary to increase energy every day to correct the energy consumption in the body. Based on the above reasons, the diet of hyperthyroidism patients must pay attention to high calorie, high protein and high vitamins and supplement calcium, phosphorus, potassium, zinc and magnesium to correct the consumption caused by high metabolism. Improve the general situation.

1) Three highs, one ban and one right amount; Refers to a high-calorie, high-protein and high-vitamin diet, avoiding breaking the dietary rules and supplementing calcium and phosphorus in moderation.

1) increase heating; Adequate carbohydrates should be given daily to correct excessive consumption, and the daily energy supply is 65,438+02,540 ~ 65,438+04,630 dry coke (3,000 ~ 3,500 kcal), which is 50% ~ 75% higher than that of normal people, so as to meet the increase of metabolic rate caused by excessive thyroxine secretion.

2) Ensure the supply of protein; Protein's daily body weight per kilogram 15g, but animal protein should be limited.

3) Pay attention to the supply of vitamins, which should be rich. Because of high metabolic energy consumption, a lot of enzymes are consumed, and various water-soluble vitamins, especially B vitamins and vitamin D, are the main vitamins to ensure the intestinal absorption of calcium and phosphorus. It is necessary to ensure the supply and supplement vitamin A and vitamin C.

4) Appropriate calcium and phosphorus supplementation; In order to prevent osteoporosis and pathological fractures, the supply of calcium and phosphorus should be appropriately increased, especially for patients and the elderly who have long been unable to control their symptoms.

5) Avoid foods and medicines containing iodine; Iodine is the raw material for synthesizing thyroid hormone. There is a lot of iodine in the thyroid gland, which accelerates the formation of thyroid hormone. Therefore, iodine can induce hyperthyroidism and aggravate the symptoms of hyperthyroidism, and iodine-containing foods and drugs should be avoided. All kinds of iodine-containing contrast agents should also be used with caution.

2) increase the number of meals;

3) Dietary allocation

1) Appropriate food selection: According to the patient's usual eating habits, you can choose various starchy foods, such as rice, noodles, steamed bread, vermicelli, potatoes, pumpkins, etc. All kinds of animal foods, such as beef, pork, mutton, all kinds of fish, etc. All kinds of fresh fruits and foods rich in calcium and phosphorus, such as milk, nuts, fresh fish, etc. You can choose oranges and apples when potassium is low.

2) Avoid choosing food; Avoid foods containing iodine, such as kelp, seaweed, Nostoc flagelliforme and iodized salt. Chinese medicines such as Muzhen Kunshi, seaweed, Prunella vulgaris, Salvia miltiorrhiza, Scrophularia, Cyperus tuber, Fritillaria thunbergii, etc. are also used locally.

3) Pay attention to the sexual and taste functions of food. From the perspective of Chinese medicine, direct selection of food has the function of nourishing yin, such as soft-shelled turtle, soft-shelled turtle and duck. Eat less warm, spicy and irritating food, such as roosters.

Treatment of hyperthyroidism

Gypsum100g, rhubarb18g (below), mirabilite12g (divided into powders), Anemarrhena asphodeloides15g, Fructus Aurantii Immaturus and Cortex Magnolia Officinalis10g. Decoct with water for15min, filter out the liquid medicine, add water for 20min, and remove the residue. Mix the two kinds of decoction evenly, daily 1 dose, and take it twice.

Radix Paeoniae Alba, Fructus Mume, Fructus Chaenomelis, Radix Adenophorae, Radix Ophiopogonis, Herba Dendrobii, Lentinus edodes, and Semen Nelumbinis each 65438+/-00g, and Radix Bupleuri, Folium Mori, and Fructus Gardeniae each 5g. Decoct with water, daily 1 dose, twice.